intermittent dispatches from steph and scott

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A word on hygiene…

I went to buy some treats at the local sweet shop today. I ordered one, thinking it would be transferred with tongs or a napkin onto a plate; instead, the guy behind the counter grabbed the soggy bite-sized piece of cake with his bare hands and held it out for me to take.

The first that time that happened, I was a little taken aback. I thought, “Oh wow– OK, well, it’s probably fine– I’m sure he’s washed his hands before coming into the kitchen just for the purpose of handing out sweets…” But in a month of traveling through Rajasthan, I’ve come to worry that each time this happens, the person has definitely not washed his hands, or has most certainly sneezed into them, 5 minutes before handling my cake. I’ve seen it happen folks.

sweet shop, Jodhpur.

If it’s not already obvious, the hygiene and sanitation we’ve experienced India has led me to the point of frustration many, many times. But I am a microbiologist, and I probably think about disease transmission more than most. Despite that, I’ve managed to overlook the fact that there was a open box of baby chicks dumped down my back on the bus yesterday (Are they carrying H5N1!? I wondered). I’ve overlooked the fact that I will not be able to wash my hands after using a public bathroom until I reach my hotel room. I tried to overlook the man that gouged away at his nostril 6 inches away from me on the bus and then wiped his finger on the pole (OK, I’ve seen that in Boston before too…). I overlook these things (or try to) because India is worth it– there are more historic, beautiful, amazing sights in India than I could see in a lifetime of traveling the country. But the lack of hygiene and the filth we’ve dealt with… well, it’s shocking, and it’s sad for such an amazing place. But I’m not just detailing my experiences for shock value here; bear with me– I have a point.

A few nights ago we were eating in a Delhi restaurant– the pots of curry at the entrance were bubbling away and the place was crowded with locals– always a good sign. As I ate my food (it was delicious), a seemingly middle-class man sitting next to us chewed on a chicken bone for a while and instead of placing the bone back onto his plate, he threw it right onto the floor under the table!

After we had finished our food, I casually watched the restaurant staff wash the dishes as we waited for our bill– they scraped the excess food of our plates, gave the dishes a quick swish in the tap water, without soap, and set them out for the next customer. I was, however, probably the only person who should have cared that they were washed without soap, as I quickly learned why they don’t need to wash the dishes. After you are given something to drink in small restaurants such as the one we were in, you are expected to pour the liquid into your mouth from some height without touching the glass to your lips… well, crap, I just drank right from the glass, I thought– how many people before me had made the same mistake?

This experience did offer some guidance though– I had read somewhere that in places like that, you can “control” the level hygiene when you dine somewhere if you eat with your hands, rather than with silverware. At first, I didn’t understand why, especially since my hands are usually dirty from touching doorknobs/money/etc all day. Now the rules for eating were becoming clear: wash the hands, eat with the hands, avoid the unwashed silverware and drinking glasses at all costs. (Apparently everyone else in the restaurant already knew the drill…)

The offending restaurant… watch for stray chicken bones…

Another enormous problem: there are no trashcans in India, it seems. We’ve been here for 3 weeks, and I did see one at a train station once. So I know they exist. Why there are not more, I do not know. What this lack of trashcans means is that, like in many developing countries, many people unfortunately throw their trash onto the sidewalk or out the window of the bus rather than holding onto it. In fact, the practice seems to be so acceptable to some people here that the following happened to us one day: we were talking to a nice guy we met on the train, and when I finished eating a bag of chips, he smiled, snatched the Lay’s bag out of my hands and tossed it right out the window for me. The only correct reply from me was a forced, meager “thanks…” Sadly, the trash not only looks and smells bad, it is eaten by the multitude of cows and dogs who roam the streets. I saw a cow chewing on a plastic bag outside of the Jaisalmer fort the other day; he swallowed it and just broke my heart at the same time.

Thankfully, the majority of the trash does not stay on the ground for long; in Jodhpur, we noticed that it was someone’s job to go around the city each morning and sweep up all the trash lying in the street into piles and haul it off in a push-cart. Now this made me think: it’s possible that when people throw their trash onto the ground or onto the train tracks, they are doing it with the realization that it is someone’s job to collect the trash later and that the trash will not just be left to rot on the street. At the least, they’re keeping the trash collector employed. But even if those reasonings were true, that trash collectors would still have jobs, even if they were collecting it from a trash bin instead of from the street, right? I don’t get it. If the cost of cans is the issue, it would be wonderful if people could get creative in an effort to keep their streets cleaner – we noticed that in Nepal, Cambodia, and Laos, people make trashcans out of woven palm fronds– something that would not cost the government a cent. When the cans are available, people seem to use them.

But candy wrappers and coke bottles are the least of one’s worries when walking around cities in Rajasthan. In the town of Jodhpur, there are cows everywhere. Which means there is poop– everywhere. Even worse, some of the cow poop gets pushed into the gutters, where it turns into a never-ending poop sludge… one that gets stepped in, tracked inside of homes, and accidentally consumed, I’m sure. (As a funny side note, one day I was walking down the street in Jodhpur, doing the usual poop-hop-shuffle, when I felt something hit the top of my head. Scott confirmed my worst fears– pigeons. Poop was coming at us from every angle!) But the most telling, eye-opening hygiene problem we saw during our time in Jodhpur was the day we visited Meharangh Fort. We were walking up a steep hill, and I was looking down as I walked– suddenly we came upon a girl, at least 8 years old– she had her dress hiked up, tush up in the air, and she was defecating in the middle of the road. Excited to see foreigners, she lifted one hand from her knees to wave and scream “hiii-iii!” to us. We waved and smiled back in blank-faced, shocked horror– sadly, all that waste we had been trying to step over wasn’t only from cows, after all. That scene brought my worries for the town to a new level entirely: transmission of human-specific diseases (Shigella spp…), concern about the level of health education– this was a new ballgame entirely.

cows…

pigeons… (I can’t make this stuff up!)

Indeed, one of the biggest problems we’ve seen in India has to be the amount of people using the sidewalks, walls, and roadways for bathroom functions instead of proper bathrooms. Unfortunately, this behavior is something we have seen in every city we’ve been to. What we can’t figure out is why it happens on such a large scale. Is there a lack of toilets that people have access to? Are there fees at the bathrooms that people can’t afford or don’t want to pay? Incredibly, the adults who engage in this kind of behavior encourage their children to do the same– waiting at the train tracks, I watched as a dad held his little girl’s hand, helped her unzip her pants, and held onto her shoulders as she peed right into the tracks below. Meanwhile, I had just used the real toilet that was 50 feet away… If the bathroom fee at train stations is the issue, would it be possible for the government to waive the payment for people who hold a train ticket, which goes toward running the railway in the first place?

Sitting at the same train station, Scott and I noticed a constant disturbing smell that would not go away. We kept asking each other, where is it coming from? Having seen the streets in front of the station in Jodhpur earlier, we knew there was a lot of human waste in front of the station along the roadway, and we figured that the smell was blowing in from the street. As soon as we strolled over to the train tracks, we couldn’t believe we hadn’t figured it out before. There were piles of human waste (unhealthy-looking waste) completely covering the tracks. One train station employee, a young guy of about 20, has the duty of cleaning the trash that ends up in the train tracks every morning. I watched him as he walked around sweeping up the trash and human waste on the tracks at Jodhpur Junction one morning, while a younger guy of maybe 15 pushed around a cart behind him to collect everything. As I watched them, I witnessed something that shocked me– a woman walked over to the tracks and leaned over to hand something to the boy– she was handing her trash (a paper cup and some bread) to the trash collector. Sadly, I had been so used to people throwing their trash onto the ground that I was surprised to see someone disposing of trash properly. But then, I watched as he carried her “trash” to the other side of the tracks where he placed it on the other side for her, so that she could jump down into the tracks, go to the other side and collect it there off the ground (where she would wait for her train). Apparently, she had just been getting his help in carrying her food to the other side; it didn’t concern her what he had just been handling and that he was now handling her food. So many instances such as these that make me sigh in frustration.

When we got on the train later that day, we found ourselves sitting across from a family: mom, dad, two young girls, baby boy, and grandma. Unfortunately, the grandma had a persistent, productive cough, and she was coughing, coughing, all the time, all over her hands, over us, everything– eventually, she picked up her little baby grandson, and, trying to pacify him, stuck her two first fingers right into the baby’s mouth for him to suck on!

But acquiring a cough would be the least of that baby’s worries that day, as in many places, babies in India sometimes don’t wear diapers– they soil their pants and the baby gets a new change of pants. That’s great; I am all for people saving resources and avoiding throw-away diapers. But as for when the baby poops, I’m not sure what the usual process is. Somehow the mom of this baby got the feeling that her baby needed to poop; she calmly removed the baby’s pants, picked him up, and held him outside the open train window so that he could go!! Thank goodness he didn’t need to go (probably got stage fright!), and she quickly pulled him back inside the moving train… But, my god!!

I should absolutely make it clear that, obviously, these hygiene issues we’ve been seeing are only a problem specific to certain people, and is not a generalization about the country as a whole. Certainly, these sanitation problems also bothered many of the Indian people who we spoke to, and to cope they have learned where the more hygienic restaurants are located and how to avoid many of the situations we encountered. It does make me wonder, then, why the education and behavior from the upper classes has not yet trickled down to the extent that I would have expected, or even why some behaviors aren’t made more culturally unacceptable within certain communities.

As an outsider, it seems so simple to address some of the problems… Install some trashcans in the city, organize a campaign to encourage people to use proper bathrooms, keep the cows in designated safe areas, encourage and institute proper hand-washing practices in restaurants, teach people about the major ways that diseases are transmitted… With some backing from an NGO or other organization, it would be so doable!! But then we moved on to the town of Jaisalmer, and then to Amritsar, and to Chopta…the hygiene problem was confronting us in the whole of India!

A stroll around Amritsar…

How does the government of almost one billion people even begin to address this one (of many) issues on such a widespread scale? It is overwhelming at best. But more importantly, where is the concern from the citizens for keeping their own country in livable conditions?

I certainly can’t begin to understand or propose solutions to the problems of the largest democracy in the world, so I’ll close with the real point that I am driving at. It, too, starts with a story: one morning in Jodhpur, we were awoken by a local man vomiting violently in his house next to our hotel. I groaned, rolled over, and tried to go back to sleep. Next morning, same thing happened again. I was annoyed at again being awoken at 5:00 in the morning by the sounds of someone’s dinner hitting the other side of the room, but I also started to feel bad for the man at the same time (rarely do I remember having a sickness that left me vomiting for more than two days in a row!)… Sadly, this exact scenario continued to play out every morning that we stayed in Jodhpur– for 6 days straight. Did this happen to this man every day of his life? I don’t claim to know why he was sick or how he acquired the condition, but hearing his sickness play out every morning helped solidify my frustration with the “hygiene problem” of India… It’s not frustrating simply because it makes the cities smelly or unsightly or difficult to visit; it’s frustrating because it is making people sick.

The girl that I saw vomiting in the street yesterday, the school kid having diarrhea on the floor of the Amritsar train station… Would they be sick (would I be sick right now??) if the sweet-shop owner had simply washed his hands (and not handled the money) before handing out that cake, or the restaurant owner had used soap on that cup between customers? It’s difficult to say. But they would sure be a healthy start.

Hi Sandy, thanks for checking out our travel blog! India was indeed very intense; glad we were able to convey some of the things we saw there to you! I’d still recommend traveling there, but it is an assault on the sense, for sure.